Provider Demographics
NPI:1780061598
Name:BYNUM, MATTHEW JAMES I (DDS)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JAMES
Last Name:BYNUM
Suffix:I
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1334 SOUTH HIGHWAY 14
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-5659
Mailing Address - Country:US
Mailing Address - Phone:864-297-5585
Mailing Address - Fax:864-297-4166
Practice Address - Street 1:1334 SOUTH HIGHWAY 14
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-5659
Practice Address - Country:US
Practice Address - Phone:864-297-5585
Practice Address - Fax:864-297-4166
Is Sole Proprietor?:No
Enumeration Date:2015-04-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3433122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist